1902003031 NPI number — DR. MICHELE MARYANN HORN-ALSBERGE PH.D.

Table of content: DR. MICHELE MARYANN HORN-ALSBERGE PH.D. (NPI 1902003031)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902003031 NPI number — DR. MICHELE MARYANN HORN-ALSBERGE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HORN-ALSBERGE
Provider First Name:
MICHELE
Provider Middle Name:
MARYANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1902003031
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
814 MONROE ST
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
STROUDSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18360-1744
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-420-9494
Provider Business Mailing Address Fax Number:
570-420-9494

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
814 MONROE ST
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-1744
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-420-9494
Provider Business Practice Location Address Fax Number:
570-420-9494
Provider Enumeration Date:
07/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PS016577 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: 35S100489200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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